Benefit Coding & Testing - Lead EBA

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JOB DESCRIPTION

Job Title

Lead EBA (IND)

Requirement Type

Full-Time Employee

Job Location

Bangalore – Bagmane

Requirement Level

Lead EBA (IND)

Hiring Manager

Assistant Manager/Manager

Primary Skill

US Healthcare Knowledge & People Management

Business

CBS Configuration

Skill Category

ABOUT ELEVANCE HEALTH

Elevance Health is a leading health company in America dedicated to improving lives and communities and making healthcare simpler. It is the largest managed health care company in the Blue Cross Blue Shield (BCBS) Association serving more than 45 million lives across 14 states.

A regular in Fortune 500 list, Elevance Health ranked 20 in 2022. Gail Boudreaux , President and CEO of Elevance Health has been a consistent name in the Fortune list of most powerful women and currently holds 4th rank on this list.

ABOUT CARELON

Carelon Global Solutions (CGS) is a healthcare solutions company that is simplifying complex operational processes to improve the health of the healthcare system.

Previously known as Legato Health Technologies, Carelon Global Solutions (hereinafter, CGS) underwent a name change and joined the Carelon family of brands in January 2023, as a fully owned subsidiary of Elevance Health (Previously Anthem Inc.). CGS brings together a global team of like-minded innovators who manage and optimize operational processes for health plans as well as providers.

Our brightest minds housed across our global headquarters in Indianapolis as well as Bengaluru, Hyderabad and Gurugram in India, Manila in the Philippines, Limerick in Ireland and San Juan in Puerto Rico bring with them innovative capabilities and an unmatched depth of experience. This global team uniquely positions CGS to enable scalable, next-generation platforms and specialized digital tools that make healthcare operations more practical, effective and efficient.

OUR MISSION & VALUES

Our Mission: Improving Lives and Communities. Simplifying Healthcare. Expecting More.
Our Values: Leadership | Community | Integrity | Agility | Diversity

JOB POSITION

Carelon Global Solutions India is seeking Lead EBA who have good US healthcare knowledge & People management skills. Preferably experience in claims, Benefit coding, testing & Configuration & Claims Testing is an added advantage.

JOB RESPONSIBILITY

Lead EBA (IND) will be responsible for the following:

Minimum 8-10 years' Experience in US Health Care. Experience in claims, Benefit coding, testing & Configuration & Claims Testing is an added advantage.
Managing the day-to-day operations
Responsible for meeting daily, weekly, monthly internal metrics (AHT, Utilization, Internal & External Quality, TAT, Productivity)
Capacity planning
Assess capacity shortages and requirement for overtime
Ensures individuals and the team meet their performance objectives
Act as a liaison with the client for any process updates, additional scope, training
Responsible for ensuring SOPs and Training Materials are up-to-date
Review capacity requirements on an ongoing basis and initiate hiring, redeployment requests as required.
Additional focus required for Open Enrollment capacity planning
Operational management including driving KRA's and feedback
Conduct timely performance appraisal for associates
Excellent knowledge on Excel & PowerPoint.
Assists in Function level reporting
Inter-team collaboration with other leaders providing assistance and seeking support wherever required
Active participation on Process improvements & Project Management.
Willing to work in US shifts.
Timely management of bottom quartiles performers
Partner connect
People Engagement

QUALIFICATION

Bachelors’ or Masters’ degree

EXPERIENCE

8 to 10 years of experience in US healthcare process

SKILLS AND COMPETENCIES

Managing the day-to-day operations
Responsible for meeting daily, weekly, monthly internal metrics (AHT, Utilization, Internal & External Quality, TAT, Productivity)
Capacity planning
Assess capacity shortages and requirement for overtime
Ensures individuals and the team meet their performance objectives
Act as a liaison with the client for any process updates, additional scope, training
Responsible for ensuring SOPs and Training Materials are up-to-date
Review capacity requirements on an ongoing basis and initiate hiring, redeployment requests as required.
Additional focus required for Open Enrollment capacity planning
Operational management including driving KRA's and feedback
Conduct timely performance appraisal for associates
Excellent knowledge on Excel & PowerPoint.
Assists in Function level reporting
Inter-team collaboration with other leaders providing assistance and seeking support wherever required
Active participation on Process improvements & Project Management.
Willing to work in US shifts.
Timely management of bottom quartiles performers
Partner connect
People Engagement

THE CARELON PROMISE

Aligning with our brand belief of ‘limitless minds are our biggest asset’, we offer a world of limitless opportunities to our associates.

It is our strong belief that one is committed to a role when it is not just what the role entails, but also what lies in its periphery that completes the value circle for an associate.

This world of limitless opportunities thrives in an environment that fosters growth and well-being, and gives you purpose and the feeling of belonging.

LIFE @ CARELON

Extensive focus on learning and development
An inspiring culture built on innovation, creativity, and freedom
Holistic well-being
Comprehensive range of rewards and recognitions
Competitive health and medical insurance coverage
Best-in-class amenities and workspaces
Policies designed with associates at the center

EQUAL OPPORTUNITY EMPLOYER

Carelon is committed to a diverse and inclusive workplace and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, disability, age, veteran status, or other characteristics.

Reasonable Accommodation

Our inclusive culture empowers Carelon to deliver the best results for our customers. We not only celebrate the diversity of our workforce, but we also celebrate the diverse ways we work.

If you have a disability and need accommodation such as an interpreter or a different interview format, please ask for the Reasonable Accommodation Request Form.

Disclaimer : Offered designation titles differ*

Set alert for similar jobsBenefit Coding & Testing - Lead EBA role in Bangalore Urban, India

Company

Carelon

Job Posted

a year ago

Job Type

Full-time

WorkMode

On-site

Experience Level

8-12 years

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